Short‐ to Midterm Results After Posterior Component Separation with Transversus Abdominis Release: Initial Experience from India

Abstract

Purpose Posterior component separation with transversus abdominis release is a new procedure and is quickly gaining popularity. It has shown promising results in terms of low recurrence rates for large and complex hernias. However, there are very little Indian data available on this to date. The purpose of this study was to assess the outcomes of the technique at three centers in India. Methods This was a retrospective analysis of the prospectively collected data. Patients with a minimum follow‐up of 3 months who underwent open or minimal access posterior component separation were included. Results A total of 72 patients (open = 44, minimal access = 25, and hybrid = 3) were included in the analysis. At a follow‐up ranging from 3 months to 35 months, there were two recurrences (2.78%). Surgical site occurrences were seen in 23/72 (31.9%), and surgical site infection was seen in 7/72 (9.7%). Surgical site occurrence requiring procedural intervention was 3/72 (4.2%). There were two (2.78%) mortalities in the open group due to myocardial infarction. Conclusion Posterior component separation with transversus abdominis release may have advantages in terms of low recurrence in large hernias in the Indian population and can be used in carefully selected patients.

Open posterior component separation with transversus abdominis release (TAR) for large incisional abdominal wall hernias: Results from a single center

“…Despite these advantages, operative times for R-TAR are longer than for open TAR [27,29]. It has been reported in the literature that the operative times for the open TAR technique range from 188 minutes to 383 minutes [14,20,[30][31][32][33][34]. The mean operative time in the present study was 248 minutes, which is comparable to the aforementioned studies.…”

Assessing Textbook Outcome After Implementation of Transversus Abdominis Release in a Regional Hospital

“…Wound complications reported in comparable studies (SSO 3-39%, SSE 3-14%, SSOPI 3-12%) resemble the results reported here, except for SSE (23%), which was high in the first episode (8,11,13,15,18,20,(45)(46)(47)(48)(49). While SSE is underreported in most studies, and no specific cause can be designated, this may be related to the TAR learning curve (8,13,15,48,49). The rate of patients without any systemic complication cannot be deduced in any other study, nor can it be adequately compared with our results.…”

“…Latest alteration in component separation techniques is the transversus abdominis release (TAR) (8)(9)(10)(11)(12)(13)(14)(15). This posterior CST was introduced in 2012 as an alternative to the classic anterior component separation technique (Ramirez) (8,16).…”

“…Division of incorrect layers lead to neurovascular lesions, semilunar hernias, interparietal herniation, and recurrences. Multiple authors mentioned a learning curve of the TAR and advised implementation only after adequate training and proctoring of the first 5-15 cases, depending on the experience in open Rives-Stoppa repair (9)(10)(11)(12)(13)(14)(15).…”

Outcomes of open transverse abdominis release for ventral hernias- A systematic review, meta-analysis and meta-regression of factors affecting them

“…We analyzed open TAR, in studies which mentioned both open and robotic data [12,21,24,25,27], we included their data for open TAR in the analysis. The recent meta-analysis comparing outcomes of open vs robotic TAR [35], concluded that though overall complications and SSO rates are low in robotic TAR, the SSOPI, SSI, reoperation and readmission rates are similar.…”